Provider Demographics
NPI:1629702055
Name:YARD, JUDY MAE (FNP-C)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MAE
Last Name:YARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:MAE
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:138 N DIXON RD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-4154
Mailing Address - Country:US
Mailing Address - Phone:765-236-8282
Mailing Address - Fax:
Practice Address - Street 1:138 N DIXON RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4154
Practice Address - Country:US
Practice Address - Phone:765-236-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71013167A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily